医源性胆管损伤致伤机制与分类初探

A preliminary study on mechanisms and classification of iatrogenic bile duct injuries

目的 探讨医源性胆管损伤发生的机制,以期对医源性胆管损伤进行合理的对临床有指导意义的分类。方法 对医源性胆管损伤的原因、方式、部位、损伤程度进行分析。结果与结论 从致伤原因上看,胆管可受到机械性损伤、热力损伤、缺血性损伤、化学性损伤等,医源性胆管损伤可分为4类,Ⅰ肝内胆管损伤,Ⅱ肝外胆管中上段损伤,Ⅲ胆总管下段损伤,Ⅳ副肝管损伤。

Objective To investigate the mechanisms of iatrogenic bile duct injuries to classify them reasonably and instructively. Methods The reasons, modes, sites and severity of the iatrogenic bile duct injuries were analyzed. Results and Conclusions Bile ducts could be injured by mechanical causes, heat, ischemia, chemical causes etc. Four types of lesions have been identified: 1) intrahepatic bile duct injury; 2) extrahepatic bile duct injury; 3) injury of inferior segment of the common bile duct; 4) accessory hepatic duct injury.